A National Imperative: Joining Forces to Strengthen Human Services in America (Jan 2018)

CASE STUDY: ORIENTING AROUND OUTCOMES IN DAKOTA COUNTY, MINNESOTA

In Dakota County, MN, it’s all about outcomes. The County’s Community Services Administration (CSA) structures all of its activities around one central question: “How are we improving the lives of our clients and communities?” Departments work together to respond to client and community needs, creating holistic service delivery approaches that aim to address root causes. They constantly look for opportunities to break down silos and deliver services based on what is needed, versus where clients show up in the system. Measuring and tracking outcomes is key. Departments report what outcomes are achieved and how clients and communities are impacted, as opposed to merely reporting dollars spent and services delivered. CBOs contract with the County under a performance-based system, where payment is dependent on the successful delivery of positive outcomes. CBOs receive additional incentive payments for exceeding performance expectations and delivering services in a collaborative, integrated fashion. The CSA is tracking outcomes based on the social determinants of health – i.e., the conditions which allow Dakota County to understand what it takes to actually move the needle – to lower rates of homelessness and substance abuse, to ensure healthy birth weights, and to increase the well-being, independence, and prosperity of the County’s citizens and communities. The CSA also uses this data to structure budget requests. Instead of proposing budgets for specific programs and services, the CSA can detail howmuch it needs to realize better outcomes. By linking funding directly to outcomes that strengthen the social determinants of health, CSA has successfully obtained budget increases every year.

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